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Updated: Jul 25, 2025

A Protocol for Comprehensive Assessment of Bulbar Dysfunction in Amyotrophic Lateral Sclerosis ALS
Published on: February 21, 2011
How to increase noninvasive ventilation effectiveness in bulbar amyotrophic lateral sclerosis patients
Jesus Sancho1,2, Santos Ferrer1,2
1Respiratory Care Unit, Respiratory Medicine Department, Hospital Clínico Universitario, Valencia, Spain.
Abstract:
Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease in which the respiratory muscles are also affected, leading to respiratory failure. Bulbar impairment develops in almost all cases during the course of the disease, becoming severe in the late stages of disease. Noninvasive ventilation (NIV) has been shown to increase survival in ALS; however, severe bulbar dysfunction has a negative impact on NIV tolerance and effectiveness. Therefore, certain steps should be taken to improve NIV outcomes in these patients including optimal ventilatory parameters, adequate interface selection, effective respiratory secretion management and control of bulbar symptoms.
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